Polypharmacy Assessment in Geriatric Patients –
Practice Exam
(150 Questions, Answers and Rationales)
2025/2026
1. Polypharmacy is commonly defined as the use of how many or
more medications?
A. 2
B. 3
C. 4
D. 5
Correct answer: D
Rationale: Polypharmacy is typically defined as the concurrent
use of five or more medications.
2. Which older adult population is at greatest risk for adverse drug
events?
A. Community-dwelling older adults
B. Nursing home residents
C. Healthy older athletes
D. Older adults taking no medications
Correct answer: B
Rationale: Nursing home residents often have multiple chronic
illnesses and high medication burdens.
3. Age-related decline in which organ most significantly affects drug
metabolism?
A. Lungs
, B. Liver
C. Skin
D. Pancreas
Correct answer: B
Rationale: The liver is responsible for most drug metabolism,
which slows with age.
4. Reduced renal clearance in older adults primarily affects which
type of drugs?
A. Lipophilic drugs
B. Protein-bound drugs
C. Hydrophilic drugs
D. Topical drugs
Correct answer: C
Rationale: Hydrophilic drugs are cleared mainly by the kidneys
and accumulate when renal function declines.
5. Which tool is commonly used to identify potentially inappropriate
medications in older adults?
A. APGAR score
B. Mini-Mental State Exam
C. Beers Criteria
D. Glasgow Coma Scale
Correct answer: C
Rationale: The Beers Criteria lists medications that are
potentially inappropriate in older adults.
6. Which of the following is a common consequence of
polypharmacy?
A. Improved adherence
B. Fewer drug interactions
C. Increased risk of falls
, D. Faster drug absorption
Correct answer: C
Rationale: Multiple medications increase sedation, dizziness, and
fall risk.
7. A major pharmacokinetic change in older adults is decreased:
A. Gastric acid secretion
B. Cardiac output
C. Renal blood flow
D. Muscle tone
Correct answer: C
Rationale: Reduced renal blood flow lowers drug clearance.
8. Which drug class most commonly contributes to falls in older
adults?
A. Antihistamines
B. Benzodiazepines
C. Antibiotics
D. Antacids
Correct answer: B
Rationale: Benzodiazepines cause sedation, dizziness, and
impaired coordination.
9. What is “prescribing cascade”?
A. Starting multiple drugs at once
B. Treating a drug side effect with another drug
C. Sudden stopping of medications
D. Using generic drugs instead of brand names
Correct answer: B
Rationale: Prescribing cascade occurs when a new medication is
added to treat a side effect of another medication.
, 10. Which of the following increases the risk of drug interactions
in older adults?
A. Taking medications with food
B. Using herbal supplements
C. Drinking water
D. Sleeping after medications
Correct answer: B
Rationale: Herbal supplements can interact with prescription
medications.
11. Which cognitive change increases the risk of medication
nonadherence in older adults?
A. Improved long-term memory
B. Decreased short-term memory
C. Increased attention span
D. Faster processing speed
Correct answer: B
Rationale: Memory decline can cause missed or duplicated
doses.
12. Which pharmacodynamic change is common with aging?
A. Increased receptor sensitivity
B. Decreased gastric motility
C. Increased renal filtration
D. Increased liver enzyme activity
Correct answer: A
Rationale: Older adults often have increased sensitivity to many
medications.
13. Which medication is considered high-risk in older adults due
to anticholinergic effects?
A. Acetaminophen
Practice Exam
(150 Questions, Answers and Rationales)
2025/2026
1. Polypharmacy is commonly defined as the use of how many or
more medications?
A. 2
B. 3
C. 4
D. 5
Correct answer: D
Rationale: Polypharmacy is typically defined as the concurrent
use of five or more medications.
2. Which older adult population is at greatest risk for adverse drug
events?
A. Community-dwelling older adults
B. Nursing home residents
C. Healthy older athletes
D. Older adults taking no medications
Correct answer: B
Rationale: Nursing home residents often have multiple chronic
illnesses and high medication burdens.
3. Age-related decline in which organ most significantly affects drug
metabolism?
A. Lungs
, B. Liver
C. Skin
D. Pancreas
Correct answer: B
Rationale: The liver is responsible for most drug metabolism,
which slows with age.
4. Reduced renal clearance in older adults primarily affects which
type of drugs?
A. Lipophilic drugs
B. Protein-bound drugs
C. Hydrophilic drugs
D. Topical drugs
Correct answer: C
Rationale: Hydrophilic drugs are cleared mainly by the kidneys
and accumulate when renal function declines.
5. Which tool is commonly used to identify potentially inappropriate
medications in older adults?
A. APGAR score
B. Mini-Mental State Exam
C. Beers Criteria
D. Glasgow Coma Scale
Correct answer: C
Rationale: The Beers Criteria lists medications that are
potentially inappropriate in older adults.
6. Which of the following is a common consequence of
polypharmacy?
A. Improved adherence
B. Fewer drug interactions
C. Increased risk of falls
, D. Faster drug absorption
Correct answer: C
Rationale: Multiple medications increase sedation, dizziness, and
fall risk.
7. A major pharmacokinetic change in older adults is decreased:
A. Gastric acid secretion
B. Cardiac output
C. Renal blood flow
D. Muscle tone
Correct answer: C
Rationale: Reduced renal blood flow lowers drug clearance.
8. Which drug class most commonly contributes to falls in older
adults?
A. Antihistamines
B. Benzodiazepines
C. Antibiotics
D. Antacids
Correct answer: B
Rationale: Benzodiazepines cause sedation, dizziness, and
impaired coordination.
9. What is “prescribing cascade”?
A. Starting multiple drugs at once
B. Treating a drug side effect with another drug
C. Sudden stopping of medications
D. Using generic drugs instead of brand names
Correct answer: B
Rationale: Prescribing cascade occurs when a new medication is
added to treat a side effect of another medication.
, 10. Which of the following increases the risk of drug interactions
in older adults?
A. Taking medications with food
B. Using herbal supplements
C. Drinking water
D. Sleeping after medications
Correct answer: B
Rationale: Herbal supplements can interact with prescription
medications.
11. Which cognitive change increases the risk of medication
nonadherence in older adults?
A. Improved long-term memory
B. Decreased short-term memory
C. Increased attention span
D. Faster processing speed
Correct answer: B
Rationale: Memory decline can cause missed or duplicated
doses.
12. Which pharmacodynamic change is common with aging?
A. Increased receptor sensitivity
B. Decreased gastric motility
C. Increased renal filtration
D. Increased liver enzyme activity
Correct answer: A
Rationale: Older adults often have increased sensitivity to many
medications.
13. Which medication is considered high-risk in older adults due
to anticholinergic effects?
A. Acetaminophen
